Managing care at home

This page covers:
• Reasons why people chose a home care agency or a self-employed a care worker
• Where to start when looking for care at home
• Keeping track of care and its costs
A lot of older people paying for social care remain at home rather than move to residential care. They may have support from family, paid home care workers, live-in care or a combination of help. Finding the right help and managing the care workers who provide it can sometimes be a challenge. Local council adult social care teams can help with this but some people prefer to make the arrangements themselves.
People who pay for their care themselves arrange care in different ways. Some people told us they liked to make arrangements directly with a care worker so that they always saw the same person. Others said they preferred to use a home care agency because they would have back-up if their usual care worker was unable to come.

Louise used to receive Christmas cards and newsletters but now she looks on the cohort study team’s Facebook page and website. She was invited to participate in a sub-study through the Facebook page.

Age at interview 64

Gender Female

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When first thinking about setting up care at home it can be difficult to know where to start. The local council adult social care department can carry out a needs assessment to help decide the level of care required. The local council can also give a list of local home (domiciliary) care agencies and the Care Quality Commission (CQC) website will have reports and quality ratings for registered providers. Hannah Googled carers in the local area but really felt it was ‘very hit and miss’. Sally had a good experience using the CQC website.
People who decided to pay individual care workers, rather than a home care agency, told us they had to think carefully about the challenges of being an employer. This could mean looking into payroll and pension responsibilities. Sue looked into employing her mum’s care workers but decided it was too much to take on. She advertised for a self-employed care worker instead.

Since being diagnosed with motor neurone disease (MND), Ian has been going for a day of tests with the research study team every six months. He is impressed by how the researchers made him feel part of the team that are researching the issue.

Age at interview 54

Gender Male

Age at diagnosis 51

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Most people told us that someone from the chosen home care agency came to meet the person needing care and talked to them and their family about what they needed. But a lot of people said that it was often quite tricky to get the care workers to come at the time of day they wanted.

Keith encourages others to take part in cohort studies. He finds the research interesting as well as hopefully improving knowledge and practice.

Age at interview 68

Gender Male

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People talked about how important it was to have good communication with the team of people providing care from the home care agency. They told us that the log book completed by care workers at each visit helps to keep track of what has been carried out.

When Mr S and his wife were invited to join a study, one of the research team confirmed they were happy to take part in Urdu.

Age at interview 35

Gender Male

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Managing care at home sometimes involves having to deal with difficulties with the care team from the home care agency. A few people told us they had opted for their care to be managed by their local council adult social care department rather than manage it themselves. They appreciated the support they got from adult social care when things were not up to standard.

John is pleased to be a data point and to see research moving forward.

Age at interview 68

Gender Male

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If the older person receiving care at home lives alone there may be times between care visits when they need support. Many people told us that much of this help between visits was covered by family members. People also helped cover these gaps by going to day centres or having occasional help from voluntary or paid companions such as the ‘befriending’ services from Age UK or the Alzheimer’s Society. One person told us about getting live-in care workers. For more about care options, see ‘What type of care is available?

Alan Z had an appointment every year for three years where he went to his doctor’s surgery for tests that lasted about half an hour.

Age at interview 86

Gender Male

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Linda felt it was appropriate that most of the feedback is about the findings of the birth cohort in general, rather than about her as an individual. She had also taken part in a separate study at a memory clinic.

Age at interview 65

Gender Female

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People told us that arranging care at home could become quite expensive especially as the amount of care needed increased. There are also additional costs to consider including equipment and adaptations to the home, keeping the home warm enough, food deliveries and other services.